Pre-eclampsia: its pathogenesis and pathophysiolgy

Pre-eclampsia is a pregnancy-specific disorder that has a worldwide prevalence of 5-8%, It is one of the main causes of maternal and perinatal morbidity and mortality globally and aocounts for 50 000-60 00 deaths annually, with a predominance in the low- and middle-income countries. It is a multi systemic disorder however its aetiology, pathogenesis and pathophysiology are poorly understood. Recently it has been postulated that it is a two-stage disease with an imbalance between angiogenic and anti-antigenic factors. This review covers the latest thoughts on the pathogenesis and pathology of pre-eclainpsia. The central hypothesis is that pre-eclampsia results from defective spiral artery remodelling, leading to cellular isehaemia in the placenta, which in turn results in an imbalance between anti-angiogenic and pro-augiagenie factors, This imbalance in favour of anti-anaiogenic factors leads to widespread endothelial dysfunction, affecting all the maternal organ systems. In addition, there is foetal growth restriction (FGR), The exact aetiology remains elusive,